Robotic surgery in gynecologic oncology: program initiation and outcomes after the first year with comparison with laparotomy for endometrial cancer staging

• Published in: American journal of obstetrics and gynecology Vol. 198; no. 6; pp. 679.e1 - 679.e10
• Main Authors: Veljovich, Dan S., MD, Paley, Pamela J., MD, Drescher, Charles W., MD, Everett, Elise N., MD, Shah, Chirag, MD, Peters, William A., MD
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01-06-2008; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Blood Loss, Surgical; endometrial carcinoma; Endometrial Neoplasms - pathology; Endometrial Neoplasms - surgery; Feasibility Studies; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Hysterectomy - methods; laparoscopy; Length of Stay; Lymph Node Excision - methods; lymphadenectomy; Medical sciences; Middle Aged; Minimally Invasive Surgical Procedures; Neoplasm Staging; Obstetrics and Gynecology; robotic surgery; Robotics; Treatment Outcome; Tumors; laparoscopy; endometrial carcinoma; lymphadenectomy; robotic surgery; Endometrium cancer; Program; Prognosis; Staging; Gynecology; Stage classification; Malignant tumor; Obstetrics; Robotics; Female genital diseases; Cancerology; Treatment; Telemedicine; Surgery; Uterine diseases; Evolution; Laparotomy; Initiation; Comparative study; Cancer
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2008.03.032

Objective The objective of the study was to evaluate outcomes during the first year of a robotic surgery program in gynecologic oncology. Study Design We studied the initiation of a robotic surgery program with prospective data collection, including intraoperative times, estimated blood loss (EBL), length of stay (LOS), lymph node yields, and complications. Patients were compared with historical and contemporary open staging surgery for endometrial cancer. Results One hundred eighteen patients underwent robotic surgery (mean age 52.5 years, body mass index of 26.3 kg/m2 , hospital stay of 32.4 hours), with 8 major and 13 minor complications. Compared with open endometrial staging (n = 131), the robotic procedure (n = 25) was longer (283 vs 139 minutes, P < .0001), had less blood loss (66.6 vs 197.6 mL, P < .0001), and had shorter length of stay (40.3 vs 127 hours, P < .0001) with comparable node yields (17.5 vs 13.1, P = .1109). Conclusion Robotic surgery is feasible in gynecologic oncology and facilitated a dramatic expansion in our minimally invasive surgical practice. Despite longer operative times, EBL and LOS are reduced and lymph node yields are comparable.